Combined ultrasound-computed tomography imaging

ABSTRACT

A system includes a medical imaging apparatus embodied for the acquisition of first items of imaging data based on electromagnetic radiation, and a control apparatus embodied to control the medical imaging apparatus and to control an ultrasound probe. The control apparatus includes an interface embodied to output control commands to the ultrasound probe. The ultrasound probe can be connected to the control apparatus via the interface.

PRIORITY STATEMENT

The present application hereby claims priority under 35 U.S.C. §119 toGerman patent application number DE 102016203812.5 filed Mar. 9, 2016,the entire contents of which are hereby incorporated herein byreference.

FIELD

At least one embodiment of the invention generally relates to a systemwith a medical imaging apparatus embodied for the acquisition of firstitems of imaging data based on electromagnetic radiation and a controlapparatus embodied to control the medical imaging apparatus and tocontrol an ultrasound probe.

At least one embodiment of the invention further generally relates to amethod for setting an operating state of a medical imaging apparatusembodied for the acquisition of first items of imaging data based onelectromagnetic radiation and to a method for the determination of atransformation for image registration of an ultrasound data set and amedical image data set recorded with electromagnetic radiation.

At least one embodiment of the invention further generally relates to amethod for the determination of a flow parameter relating to a fluidflow in a segment of a vessel, a flow parameter determining facility anda system with a flow parameter determining facility.

BACKGROUND

A combination of ultrasound imaging and imaging based on electromagneticradiation, for example computed tomography, is of interest for a varietyof reasons. Hereinafter, the combination of ultrasound (US) and computedtomography (CT) will also be called US-CT. US-CT imaging makes itpossible, for example, to improve interventions in that a CT volumeimage and an image recorded with an ultrasound biopsy probe aresuperimposed. This enables the desired region to be reached with ahigher aiming precision. When ultrasound imaging is used in addition toCT, a stand-alone ultrasound device is frequently placed next to thecomputed tomography device. A configuration of this kind is not optimalfor many applications with regard to the interaction of components ofthe ultrasound device and components of the computed tomography device.

SUMMARY

At least one embodiment of the invention enables improved interactionbetween a medical imaging apparatus embodied for the acquisition offirst items of imaging data based on electromagnetic radiation and anultrasound probe.

At least one embodiment of the invention is directed to a system; atleast one embodiment of the invention is directed to a method; at leastone embodiment of the invention is directed to another method; and atleast one embodiment of the invention is directed to a synchronizationfacility. The claims address further advantageous embodiments of theinvention.

The system according to at least one embodiment of the inventioncomprises a medical imaging apparatus embodied for the acquisition offirst items of imaging data based on electromagnetic radiation and acontrol apparatus embodied to control the medical imaging apparatus andto control an ultrasound probe. The control apparatus comprises aninterface embodied to output control commands for controlling theultrasound probe to the ultrasound probe. The ultrasound probe can beconnected to the control apparatus via the interface.

According to one embodiment of the invention, it is provided that themedical imaging apparatus comprises a gantry and/or a patient supportapparatus and/or that the mobile control unit is arranged or can bearranged on the gantry and/or on the patient support apparatus. Themobile control unit, in particular the tablet computer, can be arrangedor arrangeable in the vicinity of the patient support apparatus and/orin the vicinity of the gantry such that both the mobile control unit andthe patient supported on the patient support apparatus and/or operatingelements arranged on the gantry for operating the medical imagingapparatus are simultaneously within the user's reach. This enables theuser to be shown images in the vicinity of the patient, wherein the useris simultaneously able to operate the medical imaging apparatus.

According to one embodiment of the invention, it is provided that thesystem comprises an injection apparatus embodied for the application ofa contrast medium for the acquisition of the first items of imaging databased on electromagnetic radiation and/or for the application of anultrasound contrast medium. In particular, the injection apparatus canbe used to inject the patient with a contrast medium for the acquisitionof the first items of imaging data based on electromagnetic radiationand/or an ultrasound contrast medium simultaneously and/or substantiallysimultaneously and/or at a specified time interval. The controlapparatus can, for example, be embodied to control the injectionapparatus.

In at least one embodiment, the method for setting an operating state ofa medical imaging apparatus embodied for the acquisition of first itemsof imaging data based on electromagnetic radiation in dependence on atemporal course of a movement of an anatomical structure and/or independence on a spatial distribution of an ultrasound contrast medium inthe anatomical structure, comprises the following steps:

-   -   provision of an ultrasound data set relating to a temporal        course of a movement of the anatomical structure and/or a        spatial distribution of an ultrasound contrast medium in the        anatomical structure,    -   determination of a trigger time based on the ultrasound data        set,    -   outputting a trigger command on the onset of the trigger time,        wherein the trigger command effects the setting of the operating        state of the medical imaging apparatus.

In at least one embodiment, the method for the determination of atransformation for image registration of an ultrasound data set and amedical image data set record recorded with electromagnetic radiationrelative to one another comprises the following steps:

-   -   acquisition of first items of imaging data via a medical imaging        apparatus based on electromagnetic radiation,    -   acquisition of second items of imaging data via an ultrasound        probe,    -   acquisition of first items of locating data relating to the        ultrasound probe via a locating system selected from the        location system group consisting of a camera system, an optical        sensor system, a light reflection system, a radio        direction-finding system and combinations thereof,    -   determination of a first piece of positional information        relating to a position of the ultrasound probe relative to a        reference system of the medical imaging apparatus based on the        first items of locating data,    -   reconstruction of the medical image data set based on the first        items of imaging data,    -   generation of the ultrasound data set based on the second items        of imaging data,    -   determination of the transformation for image registration of        the ultrasound data set and the medical image data set relative        to one another based on the first piece of positional        information.

In at least one embodiment, the method for the determination of a flowparameter relating to a fluid flow in a segment of a vessel comprisesthe following steps:

-   -   provision of an ultrasound data set relating to a region to be        depicted in which the vessel is located,    -   provision of a medical image data set recorded on the basis of        electromagnetic radiation and relating to the region to be        depicted,    -   determination of positional information with which the segment        of the vessel can be localized in the ultrasound data set based        on the medical image data set,    -   determination of the flow parameter relating to the fluid flow        in the segment of the vessel relates to based on the ultrasound        data set and based on the positional information.

According to one embodiment of the invention, it is provided that thesystem is embodied to carry out a method according to one or more of theembodiments described in this application. The system is in particularembodied to carry out a given step when the system comprises a componentembodied to carry out the given step.

One embodiment of the invention provides that the control apparatus isformed by a computer and/or that one or more components of the controlapparatus are formed at least partially by a computer. The computer can,for example, comprise a memory facility and/or a processor system. Theprocessor system can, for example, comprise a microprocessor and/or aplurality of interacting microprocessors. One embodiment of theinvention provides that the control apparatus and/or one or morecomponents of the control apparatus is or are implemented at leastpartially in the form of software on a processor system.

One embodiment of the invention provides that the control apparatusand/or one or more components of the control apparatus is or areimplemented at least partially in the form of hardware. The hardwarecan, for example, be an FPGA system (Field-programmable gate array), anASIC system (application-specific integrated circuit), a microcontrollersystem, a processor system and combinations thereof. The hardware can,for example, interact with software and/or be configured by way ofsoftware. One embodiment of the invention provides that the controlapparatus and/or one or more components of the control apparatus is orare at least partially formed by a cloud via cloud computing. The cloudcan in particular comprise a network of memory regions that arespatially separated from one another and processor systems that arespatially separated from one another. The control apparatus can comprisea first cloud interface for the data transfer from the cloud and/or tothe cloud.

Data transfer between components of the control apparatus can, forexample, in each case take place via a suitable data transfer interface.One embodiment of the invention provides that data transfer interfacesfor transferring data to and/or from components of the control apparatusare implemented at least partially in the form of software and/or atleast partially in the form of hardware. In particular, the interfacescan comprises means for accessing suitable memory regions in which datacan be suitably buffered, retrieved and updated.

In particular with an extensively software-based implementation of thecontrol apparatus, a computer can be embodied by way of software suchthat the computer can carry out the steps of a method according to atleast one embodiment of the invention. Hence, the object is in each caseachieved by the computer program according to at least one embodiment ofthe invention, the computer-readable medium according to at least oneembodiment of the invention and the computer program product accordingto at least one embodiment of the invention.

The computer program according to at least one embodiment of theinvention can be loaded into a memory facility of a computer. Thecomputer program carries out the steps of a method according to at leastone embodiment of the invention when the computer program is executed onthe computer. A computer program according to at least one embodiment ofthe invention is stored on the computer-readable medium according to atleast one embodiment of the invention. In particular, thecomputer-readable medium can be embodied to transport the computerprogram and/or to store the computer program.

According to one embodiment of the invention, the computer-readablemedium is a memory stick, a hard disk or some other kind of a datamedium that can, for example, be transportable or permanently installed.The computer program according to at least one embodiment of theinvention product comprises a computer program according to theinvention and/or a computer-readable medium according to at least oneembodiment of the invention. In addition to the computer program and/orthe computer-readable medium, the computer program product can includeadditional software components, for example documentation, and/oradditional hardware components, for example a hardware key (dongle etc.)for using the software.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention is described again in more detail below with reference tothe attached figures and with reference to exemplary embodiments. Therepresentation in the figures is schematic and greatly simplified andnot necessarily true to scale. In the context of this application, aterm provided with a reference character can be understood to be anexemplary embodiment of the similarly named term which has not beengiven a reference character. If different reference characters are usedfor a term, this can in particular relate to different exemplaryembodiments for this term.

The figures show:

FIG. 1 a schematic representation of a system according to a firstembodiment of the invention,

FIG. 2 a schematic representation of a control apparatus,

FIG. 3 a schematic representation of a synchronization facilityaccording to a second embodiment of the invention,

FIG. 4 a schematic representation of a flow parameter determiningfacility,

FIG. 5 a flow diagram of a method for the determination of atransformation for image registration according to a third embodiment ofthe invention,

FIG. 6 a flow diagram of a method for setting an operating state of themedical imaging apparatus according to a fourth embodiment of theinvention,

FIG. 7 a flow diagram of a method for the determination of a flowparameter relating to a fluid flow in a segment of a vessel,

FIG. 8 a schematic representation of a vessel.

DETAILED DESCRIPTION OF THE EXAMPLE EMBODIMENTS

The drawings are to be regarded as being schematic representations andelements illustrated in the drawings are not necessarily shown to scale.Rather, the various elements are represented such that their functionand general purpose become apparent to a person skilled in the art. Anyconnection or coupling between functional blocks, devices, components,or other physical or functional units shown in the drawings or describedherein may also be implemented by an indirect connection or coupling. Acoupling between components may also be established over a wirelessconnection. Functional blocks may be implemented in hardware, firmware,software, or a combination thereof.

Various example embodiments will now be described more fully withreference to the accompanying drawings in which only some exampleembodiments are shown. Specific structural and functional detailsdisclosed herein are merely representative for purposes of describingexample embodiments. Example embodiments, however, may be embodied invarious different forms, and should not be construed as being limited toonly the illustrated embodiments. Rather, the illustrated embodimentsare provided as examples so that this disclosure will be thorough andcomplete, and will fully convey the concepts of this disclosure to thoseskilled in the art. Accordingly, known processes, elements, andtechniques, may not be described with respect to some exampleembodiments. Unless otherwise noted, like reference characters denotelike elements throughout the attached drawings and written description,and thus descriptions will not be repeated. The present invention,however, may be embodied in many alternate forms and should not beconstrued as limited to only the example embodiments set forth herein.

It will be understood that, although the terms first, second, etc. maybe used herein to describe various elements, components, regions,layers, and/or sections, these elements, components, regions, layers,and/or sections, should not be limited by these terms. These terms areonly used to distinguish one element from another. For example, a firstelement could be termed a second element, and, similarly, a secondelement could be termed a first element, without departing from thescope of example embodiments of the present invention. As used herein,the term “and/or,” includes any and all combinations of one or more ofthe associated listed items. The phrase “at least one of” has the samemeaning as “and/or”.

Spatially relative terms, such as “beneath,” “below,” “lower,” “under,”“above,” “upper,” and the like, may be used herein for ease ofdescription to describe one element or feature's relationship to anotherelement(s) or feature(s) as illustrated in the figures. It will beunderstood that the spatially relative terms are intended to encompassdifferent orientations of the device in use or operation in addition tothe orientation depicted in the figures. For example, if the device inthe figures is turned over, elements described as “below,” “beneath,” or“under,” other elements or features would then be oriented “above” theother elements or features. Thus, the example terms “below” and “under”may encompass both an orientation of above and below. The device may beotherwise oriented (rotated 90 degrees or at other orientations) and thespatially relative descriptors used herein interpreted accordingly. Inaddition, when an element is referred to as being “between” twoelements, the element may be the only element between the two elements,or one or more other intervening elements may be present.

Spatial and functional relationships between elements (for example,between modules) are described using various terms, including“connected,” “engaged,” “interfaced,” and “coupled.” Unless explicitlydescribed as being “direct,” when a relationship between first andsecond elements is described in the above disclosure, that relationshipencompasses a direct relationship where no other intervening elementsare present between the first and second elements, and also an indirectrelationship where one or more intervening elements are present (eitherspatially or functionally) between the first and second elements. Incontrast, when an element is referred to as being “directly” connected,engaged, interfaced, or coupled to another element, there are nointervening elements present. Other words used to describe therelationship between elements should be interpreted in a like fashion(e.g., “between,” versus “directly between,” “adjacent,” versus“directly adjacent,” etc.).

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of exampleembodiments of the invention. As used herein, the singular forms “a,”“an,” and “the,” are intended to include the plural forms as well,unless the context clearly indicates otherwise. As used herein, theterms “and/or” and “at least one of” include any and all combinations ofone or more of the associated listed items. It will be furtherunderstood that the terms “comprises,” “comprising,” “includes,” and/or“including,” when used herein, specify the presence of stated features,integers, steps, operations, elements, and/or components, but do notpreclude the presence or addition of one or more other features,integers, steps, operations, elements, components, and/or groupsthereof. As used herein, the term “and/or” includes any and allcombinations of one or more of the associated listed items. Expressionssuch as “at least one of,” when preceding a list of elements, modify theentire list of elements and do not modify the individual elements of thelist. Also, the term “exemplary” is intended to refer to an example orillustration.

When an element is referred to as being “on,” “connected to,” “coupledto,” or “adjacent to,” another element, the element may be directly on,connected to, coupled to, or adjacent to, the other element, or one ormore other intervening elements may be present. In contrast, when anelement is referred to as being “directly on,” “directly connected to,”“directly coupled to,” or “immediately adjacent to,” another elementthere are no intervening elements present.

It should also be noted that in some alternative implementations, thefunctions/acts noted may occur out of the order noted in the figures.For example, two figures shown in succession may in fact be executedsubstantially concurrently or may sometimes be executed in the reverseorder, depending upon the functionality/acts involved.

Unless otherwise defined, all terms (including technical and scientificterms) used herein have the same meaning as commonly understood by oneof ordinary skill in the art to which example embodiments belong. Itwill be further understood that terms, e.g., those defined in commonlyused dictionaries, should be interpreted as having a meaning that isconsistent with their meaning in the context of the relevant art andwill not be interpreted in an idealized or overly formal sense unlessexpressly so defined herein.

Before discussing example embodiments in more detail, it is noted thatsome example embodiments may be described with reference to acts andsymbolic representations of operations (e.g., in the form of flowcharts, flow diagrams, data flow diagrams, structure diagrams, blockdiagrams, etc.) that may be implemented in conjunction with units and/ordevices discussed in more detail below. Although discussed in aparticularly manner, a function or operation specified in a specificblock may be performed differently from the flow specified in aflowchart, flow diagram, etc. For example, functions or operationsillustrated as being performed serially in two consecutive blocks mayactually be performed simultaneously, or in some cases be performed inreverse order. Although the flowcharts describe the operations assequential processes, many of the operations may be performed inparallel, concurrently or simultaneously. In addition, the order ofoperations may be re-arranged. The processes may be terminated whentheir operations are completed, but may also have additional steps notincluded in the figure. The processes may correspond to methods,functions, procedures, subroutines, subprograms, etc.

Specific structural and functional details disclosed herein are merelyrepresentative for purposes of describing example embodiments of thepresent invention. This invention may, however, be embodied in manyalternate forms and should not be construed as limited to only theembodiments set forth herein.

Units and/or devices according to one or more example embodiments may beimplemented using hardware, software, and/or a combination thereof. Forexample, hardware devices may be implemented using processing circuitysuch as, but not limited to, a processor, Central Processing Unit (CPU),a controller, an arithmetic logic unit (ALU), a digital signalprocessor, a microcomputer, a field programmable gate array (FPGA), aSystem-on-Chip (SoC), a programmable logic unit, a microprocessor, orany other device capable of responding to and executing instructions ina defined manner. Portions of the example embodiments and correspondingdetailed description may be presented in terms of software, oralgorithms and symbolic representations of operation on data bits withina computer memory. These descriptions and representations are the onesby which those of ordinary skill in the art effectively convey thesubstance of their work to others of ordinary skill in the art. Analgorithm, as the term is used here, and as it is used generally, isconceived to be a self-consistent sequence of steps leading to a desiredresult. The steps are those requiring physical manipulations of physicalquantities. Usually, though not necessarily, these quantities take theform of optical, electrical, or magnetic signals capable of beingstored, transferred, combined, compared, and otherwise manipulated. Ithas proven convenient at times, principally for reasons of common usage,to refer to these signals as bits, values, elements, symbols,characters, terms, numbers, or the like.

It should be borne in mind, however, that all of these and similar termsare to be associated with the appropriate physical quantities and aremerely convenient labels applied to these quantities. Unlessspecifically stated otherwise, or as is apparent from the discussion,terms such as “processing” or “computing” or “calculating” or“determining” of “displaying” or the like, refer to the action andprocesses of a computer system, or similar electronic computingdevice/hardware, that manipulates and transforms data represented asphysical, electronic quantities within the computer system's registersand memories into other data similarly represented as physicalquantities within the computer system memories or registers or othersuch information storage, transmission or display devices.

In this application, including the definitions below, the term ‘module’or the term ‘controller’ may be replaced with the term ‘circuit.’ Theterm ‘module’ may refer to, be part of, or include processor hardware(shared, dedicated, or group) that executes code and memory hardware(shared, dedicated, or group) that stores code executed by the processorhardware.

The module may include one or more interface circuits. In some examples,the interface circuits may include wired or wireless interfaces that areconnected to a local area network (LAN), the Internet, a wide areanetwork (WAN), or combinations thereof. The functionality of any givenmodule of the present disclosure may be distributed among multiplemodules that are connected via interface circuits. For example, multiplemodules may allow load balancing. In a further example, a server (alsoknown as remote, or cloud) module may accomplish some functionality onbehalf of a client module.

Software may include a computer program, program code, instructions, orsome combination thereof, for independently or collectively instructingor configuring a hardware device to operate as desired. The computerprogram and/or program code may include program or computer-readableinstructions, software components, software modules, data files, datastructures, and/or the like, capable of being implemented by one or morehardware devices, such as one or more of the hardware devices mentionedabove. Examples of program code include both machine code produced by acompiler and higher level program code that is executed using aninterpreter.

For example, when a hardware device is a computer processing device(e.g., a processor, Central Processing Unit (CPU), a controller, anarithmetic logic unit (ALU), a digital signal processor, amicrocomputer, a microprocessor, etc.), the computer processing devicemay be configured to carry out program code by performing arithmetical,logical, and input/output operations, according to the program code.Once the program code is loaded into a computer processing device, thecomputer processing device may be programmed to perform the programcode, thereby transforming the computer processing device into a specialpurpose computer processing device. In a more specific example, when theprogram code is loaded into a processor, the processor becomesprogrammed to perform the program code and operations correspondingthereto, thereby transforming the processor into a special purposeprocessor.

Software and/or data may be embodied permanently or temporarily in anytype of machine, component, physical or virtual equipment, or computerstorage medium or device, capable of providing instructions or data to,or being interpreted by, a hardware device. The software also may bedistributed over network coupled computer systems so that the softwareis stored and executed in a distributed fashion. In particular, forexample, software and data may be stored by one or more computerreadable recording mediums, including the tangible or non-transitorycomputer-readable storage media discussed herein.

Even further, any of the disclosed methods may be embodied in the formof a program or software. The program or software may be stored on anon-transitory computer readable medium and is adapted to perform anyone of the aforementioned methods when run on a computer device (adevice including a processor). Thus, the non-transitory, tangiblecomputer readable medium, is adapted to store information and is adaptedto interact with a data processing facility or computer device toexecute the program of any of the above mentioned embodiments and/or toperform the method of any of the above mentioned embodiments.

Example embodiments may be described with reference to acts and symbolicrepresentations of operations (e.g., in the form of flow charts, flowdiagrams, data flow diagrams, structure diagrams, block diagrams, etc.)that may be implemented in conjunction with units and/or devicesdiscussed in more detail below. Although discussed in a particularlymanner, a function or operation specified in a specific block may beperformed differently from the flow specified in a flowchart, flowdiagram, etc. For example, functions or operations illustrated as beingperformed serially in two consecutive blocks may actually be performedsimultaneously, or in some cases be performed in reverse order.

According to one or more example embodiments, computer processingdevices may be described as including various functional units thatperform various operations and/or functions to increase the clarity ofthe description. However, computer processing devices are not intendedto be limited to these functional units. For example, in one or moreexample embodiments, the various operations and/or functions of thefunctional units may be performed by other ones of the functional units.Further, the computer processing devices may perform the operationsand/or functions of the various functional units without sub-dividingthe operations and/or functions of the computer processing units intothese various functional units.

Units and/or devices according to one or more example embodiments mayalso include one or more storage devices. The one or more storagedevices may be tangible or non-transitory computer-readable storagemedia, such as random access memory (RAM), read only memory (ROM), apermanent mass storage device (such as a disk drive), solid state (e.g.,NAND flash) device, and/or any other like data storage mechanism capableof storing and recording data. The one or more storage devices may beconfigured to store computer programs, program code, instructions, orsome combination thereof, for one or more operating systems and/or forimplementing the example embodiments described herein. The computerprograms, program code, instructions, or some combination thereof, mayalso be loaded from a separate computer readable storage medium into theone or more storage devices and/or one or more computer processingdevices using a drive mechanism. Such separate computer readable storagemedium may include a Universal Serial Bus (USB) flash drive, a memorystick, a Blu-ray/DVD/CD-ROM drive, a memory card, and/or other likecomputer readable storage media. The computer programs, program code,instructions, or some combination thereof, may be loaded into the one ormore storage devices and/or the one or more computer processing devicesfrom a remote data storage device via a network interface, rather thanvia a local computer readable storage medium. Additionally, the computerprograms, program code, instructions, or some combination thereof, maybe loaded into the one or more storage devices and/or the one or moreprocessors from a remote computing system that is configured to transferand/or distribute the computer programs, program code, instructions, orsome combination thereof, over a network. The remote computing systemmay transfer and/or distribute the computer programs, program code,instructions, or some combination thereof, via a wired interface, an airinterface, and/or any other like medium.

The one or more hardware devices, the one or more storage devices,and/or the computer programs, program code, instructions, or somecombination thereof, may be specially designed and constructed for thepurposes of the example embodiments, or they may be known devices thatare altered and/or modified for the purposes of example embodiments.

A hardware device, such as a computer processing device, may run anoperating system (OS) and one or more software applications that run onthe OS. The computer processing device also may access, store,manipulate, process, and create data in response to execution of thesoftware. For simplicity, one or more example embodiments may beexemplified as a computer processing device or processor; however, oneskilled in the art will appreciate that a hardware device may includemultiple processing elements or porcessors and multiple types ofprocessing elements or processors. For example, a hardware device mayinclude multiple processors or a processor and a controller. Inaddition, other processing configurations are possible, such as parallelprocessors.

The computer programs include processor-executable instructions that arestored on at least one non-transitory computer-readable medium (memory).The computer programs may also include or rely on stored data. Thecomputer programs may encompass a basic input/output system (BIOS) thatinteracts with hardware of the special purpose computer, device driversthat interact with particular devices of the special purpose computer,one or more operating systems, user applications, background services,background applications, etc. As such, the one or more processors may beconfigured to execute the processor executable instructions.

The computer programs may include: (i) descriptive text to be parsed,such as HTML (hypertext markup language) or XML (extensible markuplanguage), (ii) assembly code, (iii) object code generated from sourcecode by a compiler, (iv) source code for execution by an interpreter,(v) source code for compilation and execution by a just-in-timecompiler, etc. As examples only, source code may be written using syntaxfrom languages including C, C++, C#, Objective-C, Haskell, Go, SQL, R,Lisp, Java®, Fortran, Perl, Pascal, Curl, OCaml, Javascript®, HTML5,Ada, ASP (active server pages), PHP, Scala, Eiffel, Smalltalk, Erlang,Ruby, Flash®, Visual Basic®, Lua, and Python®.

Further, at least one embodiment of the invention relates to thenon-transitory computer-readable storage medium including electronicallyreadable control information (procesor executable instructions) storedthereon, configured in such that when the storage medium is used in acontroller of a device, at least one embodiment of the method may becarried out.

The computer readable medium or storage medium may be a built-in mediuminstalled inside a computer device main body or a removable mediumarranged so that it can be separated from the computer device main body.The term computer-readable medium, as used herein, does not encompasstransitory electrical or electromagnetic signals propagating through amedium (such as on a carrier wave); the term computer-readable medium istherefore considered tangible and non-transitory. Non-limiting examplesof the non-transitory computer-readable medium include, but are notlimited to, rewriteable non-volatile memory devices (including, forexample flash memory devices, erasable programmable read-only memorydevices, or a mask read-only memory devices); volatile memory devices(including, for example static random access memory devices or a dynamicrandom access memory devices); magnetic storage media (including, forexample an analog or digital magnetic tape or a hard disk drive); andoptical storage media (including, for example a CD, a DVD, or a Blu-rayDisc). Examples of the media with a built-in rewriteable non-volatilememory, include but are not limited to memory cards; and media with abuilt-in ROM, including but not limited to ROM cassettes; etc.Furthermore, various information regarding stored images, for example,property information, may be stored in any other form, or it may beprovided in other ways.

The term code, as used above, may include software, firmware, and/ormicrocode, and may refer to programs, routines, functions, classes, datastructures, and/or objects. Shared processor hardware encompasses asingle microprocessor that executes some or all code from multiplemodules. Group processor hardware encompasses a microprocessor that, incombination with additional microprocessors, executes some or all codefrom one or more modules. References to multiple microprocessorsencompass multiple microprocessors on discrete dies, multiplemicroprocessors on a single die, multiple cores of a singlemicroprocessor, multiple threads of a single microprocessor, or acombination of the above.

Shared memory hardware encompasses a single memory device that storessome or all code from multiple modules. Group memory hardwareencompasses a memory device that, in combination with other memorydevices, stores some or all code from one or more modules.

The term memory hardware is a subset of the term computer-readablemedium. The term computer-readable medium, as used herein, does notencompass transitory electrical or electromagnetic signals propagatingthrough a medium (such as on a carrier wave); the term computer-readablemedium is therefore considered tangible and non-transitory. Non-limitingexamples of the non-transitory computer-readable medium include, but arenot limited to, rewriteable non-volatile memory devices (including, forexample flash memory devices, erasable programmable read-only memorydevices, or a mask read-only memory devices); volatile memory devices(including, for example static random access memory devices or a dynamicrandom access memory devices); magnetic storage media (including, forexample an analog or digital magnetic tape or a hard disk drive); andoptical storage media (including, for example a CD, a DVD, or a Blu-rayDisc). Examples of the media with a built-in rewriteable non-volatilememory, include but are not limited to memory cards; and media with abuilt-in ROM, including but not limited to ROM cassettes; etc.Furthermore, various information regarding stored images, for example,property information, may be stored in any other form, or it may beprovided in other ways.

The apparatuses and methods described in this application may bepartially or fully implemented by a special purpose computer created byconfiguring a general purpose computer to execute one or more particularfunctions embodied in computer programs. The functional blocks andflowchart elements described above serve as software specifications,which can be translated into the computer programs by the routine workof a skilled technician or programmer.

Although described with reference to specific examples and drawings,modifications, additions and substitutions of example embodiments may bevariously made according to the description by those of ordinary skillin the art. For example, the described techniques may be performed in anorder different with that of the methods described, and/or componentssuch as the described system, architecture, devices, circuit, and thelike, may be connected or combined to be different from theabove-described methods, or results may be appropriately achieved byother components or equivalents.

The system according to at least one embodiment of the inventioncomprises a medical imaging apparatus embodied for the acquisition offirst items of imaging data based on electromagnetic radiation and acontrol apparatus embodied to control the medical imaging apparatus andto control an ultrasound probe. The control apparatus comprises aninterface embodied to output control commands for controlling theultrasound probe to the ultrasound probe. The ultrasound probe can beconnected to the control apparatus via the interface.

The medical imaging apparatus can in particular be anon-ultrasound-based medical imaging apparatus. The medical imagingapparatus can, for example, be a tomography device and/or comprise atomography device. The medical imaging apparatus can, for example, beembodied to reconstruct a medical image data set based on the firstitems of imaging data. Without restricting the general concept of theinvention, in some of the embodiments of the invention described, theterm computed tomography device can be used by way of example for themedical imaging apparatus.

According to one embodiment of the invention, the medical imagingapparatus is selected from the imaging modalities group consisting of anX-ray device, a C-arm X-ray device, a computed tomography device (CTdevice), a single photon emission computed tomography device (SPECTdevice), a positron emission tomography device (PET device), a magneticresonance imaging device (MRI device) and combinations thereof. Themedical imaging apparatus can further comprise a combination of animaging modality selected, for example, from the imaging modalitiesgroup, and an irradiation modality. In this case, the irradiationmodality can, for example, comprise an irradiation unit for therapeuticirradiation.

According to one embodiment of the invention, the medical imagingapparatus comprises an imaging data acquisition unit embodied for theacquisition of the first items of imaging data. In particular, theimaging data acquisition unit can comprise a radiation source and aradiation detector. One embodiment of the invention provides that theradiation source is embodied for the emission and/or excitation ofradiation, in particular electromagnetic radiation and/or that theradiation detector is embodied to detect the radiation, in particularthe electromagnetic radiation. The radiation can, for example, travelfrom the radiation source to a region to be depicted and/or, followinginteraction with the region to be depicted, travel to the radiationdetector. On interaction with the region to be depicted, the radiationis modified and hence becomes a carrier of information relating to theregion to be depicted. On the interaction of radiation with thedetector, this information is acquired in the form of the first items ofimaging data.

In particular in the case of a computed tomography device, the firstitems of imaging data can be projection data, the imaging dataacquisition unit a projection data acquisition unit, the radiationsource an X-ray source and the radiation detector an X-ray detector. TheX-ray detector can in particular be a quantum-counting and/orenergy-resolving X-ray detector. Without restricting the general conceptof the invention, in some of the embodiments of the invention described,X-rays are named by way of example for the electromagnetic radiation. Inparticular in the case of a magnetic resonance imaging device, the firstitems of imaging data can be a magnetic resonance imaging data set, theimaging data acquisition unit a magnetic resonance imaging dataacquisition unit, the radiation source a first radio-frequency antenna,the radiation detector the first radio-frequency antenna and/or a secondradio-frequency antenna.

The ultrasound probe can, for example, be embodied to convert anelectronic transmit signal into ultrasound, to output ultrasound, toreceive ultrasound, to convert the ultrasound received into anelectronic received signal, to convert the electronic received signalinto second imaging data and/or to output the second items of imagingdata. The electronic received signal can in particular be an analogelectronic received signal. The second items of imaging data can inparticular be digital second items of imaging data.

According to one embodiment of the invention, the ultrasound probecomprises a data transmission module embodied to receive the controlcommands from the interface and/or to output the second items of imagingdata to the interface. The data transmission module can, for example,comprise a data transmission connection embodied for direct datatransmission of the control commands from the interface and/or fordirect data transmission of the second items of imaging data to theinterface. The data transmission connector can, for example, be selectedfrom the group consisting of a USB connector, a FireWire connector, aBluetooth connector and combinations thereof. The direct datatransmission can, for example, be cable-connected and/or wireless.Direct data transmission can in particular be understood to mean datatransmission with which there are no data-processing steps, inparticular no buffers and no amendments to the data transmissionprotocol, on the data transmission path between the interface and thedata transmission connector.

According to one embodiment of the invention, the ultrasound probecomprises a beam former, an ultrasound converter array, receiveramplifiers and/or analog-to-digital converters. The beam former can, forexample, comprise pulse generators, a memory element, a timer element, atime delay circuit, phase regulators and/or amplifiers. The ultrasoundconverter array can, for example, comprise a plurality of individualconverters. The ultrasound converter array can, for example, comprise64, 128 or 256 individual converters. The individual converters in theplurality of individual converters can, for example, each be based onthe piezo effect and/or embodied to convert electrical energy intoacoustic energy and/or to convert acoustic energy into electricalenergy. The ultrasound converter array can, for example, be a phasedarray. In particular, the beam former and the ultrasound converter arraycan interact such that the outputting of ultrasound and/or the receptionof ultrasound can both be achieved with a high degree of directionality.

The ultrasound probe can, for example, comprise a first housing and/or asecond housing. The first housing can, for example, be dimensionedand/or shaped such that a user can hold the first housing with a firsthand and guide it around a patient for the acquisition of second itemsof imaging data of a region to be depicted of the patient. The secondhousing can, for example, dimensioned and/or shaped such that the usercan carry the second housing by way of a carrying apparatus, for examplea carrying belt and/or hold it in a second hand while holding the firsthousing with the first hand and guiding it round the patient. Accordingto one embodiment of the invention, the ultrasound converter arrayand/or the data transmission module is located in the first housing.According to one embodiment of the invention, all components of theultrasound probe are located in the first housing. The beam former, thedata transmission module, further components of the ultrasound probeand/or a battery to provide power to components of the ultrasound probecan each, for example, be located in the first housing and/or in thesecond housing. The first housing and the second housing can, forexample, be connected to one another via a loom of cables for thetransmission of electrical energy and/or electronic signals. Theultrasound probe can, for example, be an ultrasound biopsy probe.

According to one embodiment of the invention, the medical imagingapparatus comprises the control apparatus. The control apparatus isembodied to generate control commands to control the ultrasound probeand/or output the commands to the ultrasound probe via the interface.The connection of the ultrasound probe to the control apparatus via theinterface can, for example, be cable-connected and/or wireless. Thecontrol commands can, for example, switch the output of ultrasound onand/or off and/or set one or more parameters of the ultrasound outputand/or select a region of the patient to be examined via ultrasound.Parameters of the ultrasound output can, for example, be a power, afrequency, an alignment of an ultrasound bundle or the like.

In particular, the control commands can comprise control signals withwhich the beam former is controlled and/or pulse generators of the beamformer are each individually controlled. The control commands can, forexample, be used to set and/or adapt an operating mode of the ultrasoundprobe. The operating mode of the ultrasound probe can, for example, beselected from the operating mode group consisting of a B-mode operatingmode, an M-mode operating mode, a 1D-operating mode, a 2D-operatingmode, a 3D-operating mode, a 4D-operating mode, a Doppler operatingmode, a color Doppler operating mode, a spectral Doppler operating mode,a contrast medium operating mode and combinations thereof.

At least one embodiment of the invention in particular enables theoperation of an ultrasound probe by way of the control apparatus of amedical imaging apparatus embodied for the acquisition of first items ofimaging data based on electromagnetic radiation. In particular, thehardware of the computers forming the control apparatus of the medicalimaging apparatus can hence be used in a cost-saving manner to controlthe ultrasound probe. In addition, a patient support apparatus,positioning cushions, an input apparatus and an output apparatus of themedical imaging apparatus can be used in a cost-saving manner forultrasound imaging by way of the ultrasound probe.

According to one embodiment of the invention, it is provided that thesystem comprises the ultrasound probe.

According to one embodiment of the invention, it is provided that theultrasound probe is embodied for the acquisition of second items ofimaging data. The second items of imaging data can, for example, relateto a region to be depicted, in particular a region to be depicted of apatient, wherein an anatomical structure is located in the region to bedepicted. The second items of imaging data can, for example, comprisefor each individual converter of the plurality of individual convertersthe individual converter imaging data assigned to the individualconverter relating to the ultrasound received and/or converted by theindividual converter.

According to one embodiment of the invention, it is provided that theinterface is embodied to receive the second items of imaging data fromthe ultrasound probe.

According to one embodiment of the invention, it is provided that thecontrol apparatus comprises an ultrasound data set generation moduleembodied for the generation of an ultrasound data set based on thesecond items of imaging data. The ultrasound data set can, for example,comprise spatially-resolved ultrasound image data and/orspatially-resolved ultrasound scan data. In particular, the ultrasoundimage data can relate to an image value, representing, for example, theintensity and/or the amplitude of ultrasound, which was reflected and/ortransmitted in the region to be depicted. In particular, the ultrasoundscan data can relate to a scan value acquired, for example via a Dopplermethod. A scan value of this kind can, for example, be a flow parameterrelating to a fluid flow in a sub-region of a vessel. The ultrasounddata set can, for example, comprise an ultrasound image with a pluralityof image points, wherein each image point of the plurality of imagepoints is assigned an image value and/or a scan value. The ultrasounddata set can, for example, comprise an ultrasound image data set with aplurality of ultrasound images.

According to one embodiment of the invention, it is provided that theultrasound probe is connected to the control apparatus via theinterface.

According to one embodiment of the invention, it is provided that theinterface is an open and/or universal interface. The interface can, forexample, be a serial interface. In particular, the interface can beembodied to connect various peripheral devices to the control apparatus.The interface can be embodied in the form of both software, for examplein the form of a data transmission protocol, and in the form ofhardware, for example in the form of a plug-in connection and/or anantenna.

According to one embodiment of the invention, it is provided that theinterface is selected from the interface group consisting of a UniversalSerial Bus (USB) interface, a FireWire interface, a Bluetooth interfaceand combinations thereof.

According to one embodiment of the invention, it is provided that thecontrol apparatus comprises a mobile control unit and/or that the mobilecontrol unit comprises the interface.

The mobile control unit can, for example, comprise the ultrasound dataset generation module. The mobile control unit can, for example, beconnected to a stationary part of the control apparatus in acable-connected or wireless manner. According to one embodiment of theinvention, the mobile control unit is embodied to display a medicalimage data set reconstructed via the medical imaging apparatus based onthe first items of imaging data and/or to display an ultrasound data setgenerated based on the second items of imaging data. According to oneembodiment of the invention, the mobile control unit is embodied togenerate control commands to control the ultrasound probe and/or togenerate control commands to control the medical imaging apparatus. Thecontrol commands for controlling the medical imaging apparatus can, forexample, be used to select a region to be depicted via the medicalimaging apparatus of the patient and/or to start or finish theacquisition of first items of imaging data. The mobile control unit can,for example, comprise a touch-sensitive screen.

According to one embodiment of the invention, it is provided that themobile control unit is a tablet computer.

According to one embodiment of the invention, software to control theultrasound probe and/or to process the second items of imaging dataand/or for the graphical display of the ultrasound data set is executedon the tablet computer.

According to one embodiment of the invention, it is provided that themedical imaging apparatus comprises a gantry and/or a patient supportapparatus and/or that the mobile control unit is arranged or can bearranged on the gantry and/or on the patient support apparatus. Themobile control unit, in particular the tablet computer, can be arrangedor arrangeable in the vicinity of the patient support apparatus and/orin the vicinity of the gantry such that both the mobile control unit andthe patient supported on the patient support apparatus and/or operatingelements arranged on the gantry for operating the medical imagingapparatus are simultaneously within the user's reach. This enables theuser to be shown images in the vicinity of the patient, wherein the useris simultaneously able to operate the medical imaging apparatus.

According to one embodiment of the invention, it is provided that thesystem comprises an injection apparatus embodied for the application ofa contrast medium for the acquisition of the first items of imaging databased on electromagnetic radiation and/or for the application of anultrasound contrast medium. In particular, the injection apparatus canbe used to inject the patient with a contrast medium for the acquisitionof the first items of imaging data based on electromagnetic radiationand/or an ultrasound contrast medium simultaneously and/or substantiallysimultaneously and/or at a specified time interval. The controlapparatus can, for example, be embodied to control the injectionapparatus.

According to one embodiment of the invention, it is provided that thesystem comprises a location system selected from the location systemgroup consisting of a camera system, an optical sensor system, a lightreflection system, a radio direction-finding system and combinationsthereof. The location system is embodied for the acquisition of firstitems of locating data relating to the ultrasound probe and/or for theacquisition of second items of locating data relating to a patient.

The location system can, for example, comprise a first subsystem for theacquisition of the first items of locating data and/or a secondsubsystem for the acquisition of the second items of locating data. Thefirst subsystem and/or the second subsystem can, for example, beselected from the group consisting of a camera system, an optical sensorsystem, a light reflection system, a radio direction-finding system andcombinations thereof. The optical sensor system can, for example, beembodied to scan the surface of the patient, wherein 2D-positional dataand/or 3D-positional data can be generated from the surface of thepatient. The first items of locating data can, for example, relate to aposition, an alignment and/or a holding angle of the ultrasound probe.

The ultrasound probe can, for example, be acquired directly via theoptical sensor system. Alternatively or additionally, infraredreflectors, which can be acquired via the optical sensor system, can bearranged on the ultrasound probe. The radio direction-finding systemcan, for example, be based on the triangulation of radio signals. Thecontrol apparatus can, for example, be embodied to control the locationsystem.

According to one embodiment of the invention, the control apparatusfurther comprises the following components:

-   -   a first positional information determining module embodied to        determine a first piece of positional information relating to a        position of the ultrasound probe relative to a reference system        of the medical imaging apparatus based on the first items of        locating data,    -   a transformation determining module embodied for the        determination of a transformation for image registration of an        ultrasound data set and a medical image data set relative to one        another based on the first piece of positional information. The        image registration can, for example, be based on an elastic        model.

According to one embodiment of the invention the control apparatusfurther comprises the following components:

-   -   a fusion image generating module embodied for the generation of        a fusion image based on the ultrasound data set, the medical        image and the transformation for image registration of the        ultrasound data set and the medical image data set,    -   a fusion image output module embodied to output the fusion        image.

The fusion image can, for example, comprise the ultrasound image and themedical image, wherein the ultrasound image and the medical image areregistered relative to one another by way of the transformation forimage registration. The outputting of the fusion image can include adisplay of the fusion image, in particular via a display apparatus.Alternatively or additionally thereto, the outputting of the fusionimage can include a data transmission of the fusion image and/or astorage of the fusion image in an image data memory facility, forexample an image database.

The fusion image can, for example, be output via a screen in the form ofa two-dimensional graphical display and/or via a virtual-realityapparatus as part of a virtual reality. The virtual reality can, forexample, comprise the fusion image and/or further image elements, forexample markings for positions of probes and/or needles.

According to one embodiment of the invention, the control apparatusfurther comprises the following components:

-   -   a second positional information determining module embodied to        determine second positional information relating to a position        of the patient relative to the reference system of the medical        imaging apparatus based on the second items of locating data    -   an augmented-reality information generating module embodied for        the generation of augmented-reality information based on the        fusion image and based on the second positional information,        wherein augmented-reality information can be used to display the        fusion image superimposed on the patient,    -   an augmented-reality information output module embodied to        output the augmented-reality information.

Augmented-reality information can in particular be understood to beinformation with which a reality, in particular the field of view of auser can be augmented. In particular, the augmented-reality informationcan be used to generate augmented reality on the basis of the field ofview of the user. The augmented-reality information can in particular beoutput such that the field of view of the first user is augmented by theaugmented-reality information. The outputting of the augmented-realityinformation can include the display of the augmented-realityinformation, in particular via an augmented-reality apparatus.Alternatively or additionally thereto, the outputting of theaugmented-reality information can include data transmission of theaugmented-reality information and/or storage of the augmented-realityinformation in an image data memory facility, for example an imagedatabase.

According to one embodiment of the invention, the system comprises anaugmented-reality apparatus. The augmented-reality information can, forexample, be generated and/or displayed via the augmented-realityapparatus. The term “device for generating augmented reality” and theterm “augmented-reality apparatus” are used synonymously. Theenhancement of reality is in particular known to the person skilled inthe art by the term “augmentation”. Enhanced reality is in particularknown to the person skilled in the art in particular by the term“augmented reality”. An enhanced-reality apparatus is in particularknown to the person skilled in the art by the term “augmented-realitydevice”.

According to one embodiment of the invention, the system comprises athird positional information determining module embodied to determinethird positional information relating to a position of theaugmented-reality apparatus relative to the reference system of themedical imaging apparatus.

One embodiment of the invention provides that a position and/or adirection of view of the user of the augmented-reality apparatus isdetermined and/or that a position and/or an alignment of the firstaugmented-reality apparatus is determined. The augmented-realityinformation can, for example, be generated based on the position and/orthe direction of view of the user and/or based on the position and/orthe alignment of the first augmented-reality apparatus. This can, forexample, take place via the locating system and/or by way of movementinformation. The movement information can, for example, be acquired viaone more acceleration sensors. In particular, the firstaugmented-reality apparatus can comprise one or more accelerationsensors.

In the case of more complex interventions (for example radio-frequencyablation, cryoablation or similar types of ablation of, for example,liver tumors and/or metastases) it is, for example, possible first toacquire a medical image data set, for example a CT volume image dataset, from the target region via the medical imaging apparatus acquired.The location system, for example the optical sensor system, and/orspatial tracking of the ultrasound head of ultrasound probe during theacquisition of the second items of imaging data can be used to registerthe medical image data set relative to the patient in three-dimensionalspace. This enables the medical image data set together with theultrasound data set to be displayed superimposed on the patient in realtime in the form of augmented-reality information during anultrasound-guided intervention.

In at least one embodiment, the method for setting an operating state ofa medical imaging apparatus embodied for the acquisition of first itemsof imaging data based on electromagnetic radiation in dependence on atemporal course of a movement of an anatomical structure and/or independence on a spatial distribution of an ultrasound contrast medium inthe anatomical structure, comprises the following steps:

-   -   provision of an ultrasound data set relating to a temporal        course of a movement of the anatomical structure and/or a        spatial distribution of an ultrasound contrast medium in the        anatomical structure,    -   determination of a trigger time based on the ultrasound data        set,    -   outputting a trigger command on the onset of the trigger time,        wherein the trigger command effects the setting of the operating        state of the medical imaging apparatus.

According to one embodiment of the invention, the following steps areprovided:

-   -   acquisition of second items of imaging data of a region to be        depicted in which the anatomical structure is located via an        ultrasound probe,    -   generation of the ultrasound data set based on the second items        of imaging data.

According to one embodiment of the invention, the following step isprovided:

-   -   acquisition of the first items of imaging data via the medical        imaging apparatus based on the electromagnetic radiation.

The determination of the trigger time based on the ultrasound data setcan include an automatic evaluation of the temporal course of themovement of the anatomical structure and/or the spatial distribution ofthe ultrasound contrast medium in the anatomical structure based on theultrasound data set. Alternatively and/or additionally to the temporalcourse of the movement of the anatomical structure, the automaticevaluation can take account of a variable derived from the temporalcourse or a further course derived from the temporal course. This inparticular includes a temporal derivation of the temporal course. Theautomatic evaluation can, for example, include the determination of adeviation of the temporal course, of the further course and/or thederived variable from one or more prespecified courses and/or variables.The spatial distribution of the ultrasound contrast medium in theanatomical structure can in particular include information on a temporalcourse of the spatial distribution of the ultrasound contrast medium inthe anatomical structure. The dependence of a spatial distribution of anultrasound contrast medium in the anatomical structure can in particularbe or comprise a dependence of a temporal course of the spatialdistribution of an ultrasound contrast medium in the anatomicalstructure. Alternatively and/or additionally to the spatial distributionof the ultrasound contrast medium in the anatomical structure, theautomatic evaluation can take account of a variable derived from thespatial distribution or a further spatial distribution derived from thespatial distribution. This in particular includes a gradient of thespatial distribution and/or a temporal course of a gradient of thespatial distribution. The automatic evaluation can, for example, includethe determination of a deviation of the spatial distribution, thefurther spatial distribution and/or the derived variable from one ormore prespecified courses and/or variables.

The automatic evaluation can, for example, take place at prespecified,in particular regularly spaced, times. The trigger time can, forexample, be the time at which the automatic evaluation reveals that thedeviation determined falls below or exceeds a prespecified referencedeviation. Alternatively, the trigger time can, for example, follow thistime at a prespecified time distance.

The trigger command can, for example, be output in the form of a voltageand/or current pulse, a data packet or an instruction implemented insoftware and/or received by the control apparatus of the medical imagingapparatus. The control apparatus can in particular be embodied to setthe operating state such that the operating state is set when thetrigger command is received by the control apparatus. In this way, thetrigger command can affect the setting of the operating state.

At least one embodiment of the described method for setting an operatingstate enables the operating state in particular to be set in temporalrelationship to a movement of an anatomical structure and/or a temporalcourse of a distribution of a contrast medium due to blood flow. Thesetting of the operating state then in particular takes place independence on a temporal course of a movement of an anatomical structureand/or in dependence on a spatial distribution of an ultrasound contrastmedium in the anatomical structure when the temporal course of amovement of an anatomical structure and/or the spatial distribution ofthe ultrasound contrast medium in the anatomical structure is used asthe basis for the determination of a time the onset of which results inthe setting of the operating state. Such a time can, for example, be thetime of the trigger command, wherein the trigger command effects thesetting of the operating state.

The operating state of the medical imaging apparatus can in particularbe the acquisition operating state. The acquisition operating state canin particular be understood to be an operating state of the medicalimaging apparatus in which the first items of imaging data are acquired.During the acquisition of the first items of imaging data, theelectromagnetic radiation is typically generated via a radiation sourcesuch that the radiation can travel from the radiation source to a regionto be depicted of a patient and, following interaction with the regionto be depicted, travel to the radiation detector. The setting of theacquisition operating state in particular comprises the setting and/orchanging of one or more parameters relating to the acquisition. Suchparameters can, for example, be electronic and/or electromagneticparameters. An electronic and/or electromagnetic parameter can inparticular be understood to be a cathode current, an intensity ofgenerated radiation or a power received and/or emitted by a radiationsource.

With a combined computed tomography-ultrasound system, it would, forexample, be conceivable, first to use the ultrasound component tomeasure the dynamics of the myocardium (heart muscle) relative to theheartbeat phase. The information can be used for the precise timing ofthe CT examination. This enables the time window of the application ofthe X-ray dose within the cardiac cycle to be optimized. This enables ahigher hit accuracy to be ensured and/or the X-ray dose to be reduced.

Compared to conventional methods requiring a relatively expensivecomputed tomography device with high temporal resolution to producehigh-quality coronary CT angiograms, the described method of at leastone embodiment for setting the operating state enables the production ofhigh-quality coronary CT angiograms with a less expensive computedtomography device with a lower temporal resolution. Alternatively, it ispossible within certain limits, in the absence of a computed tomographydevice with high temporal resolution to obtain acceptable images by amore intensive use of the X-ray dose in that instead of (dose-saving)retrospective sequential recording methods, other (more dose-intensive)gating methods are used. By way of comparison, the invention enables theX-ray dose to be reduced.

For optimal acquisition of first items of imaging data, for exampleduring vascular recording (arterial phase), it may be necessary todetermine the time delay between the injection of a contrast medium andthe acquisition. This can, for example, be performed prospectively via atest bolus and/or via bolus monitoring. In both cases, in addition toelectromagnetic radiation, for example X-rays, and/or the contrastmedium for the actual acquisition, further electromagnetic radiationand/or, in particular with a test bolus, also additional contrast mediumis applied.

With a combined computed tomography-ultrasound system comprising aninjection apparatus coupled to the control apparatus, the time delaybetween the injection and the arrival of the contrast medium in thevessels to be examined could be determined via the ultrasound probe andthe ultrasound contrast medium without additional exposure to X-rays oran iodine contrast medium. The time delay can be used as the basis fordetermining the trigger time and outputting the trigger command. For apracticed ultrasound user, this would typically not require any moretime than an examination via a test bolus.

In at least one embodiment, the method for the determination of atransformation for image registration of an ultrasound data set and amedical image data set record recorded with electromagnetic radiationrelative to one another comprises the following steps:

-   -   acquisition of first items of imaging data via a medical imaging        apparatus based on electromagnetic radiation,    -   acquisition of second items of imaging data via an ultrasound        probe,    -   acquisition of first items of locating data relating to the        ultrasound probe via a locating system selected from the        location system group consisting of a camera system, an optical        sensor system, a light reflection system, a radio        direction-finding system and combinations thereof,    -   determination of a first piece of positional information        relating to a position of the ultrasound probe relative to a        reference system of the medical imaging apparatus based on the        first items of locating data,    -   reconstruction of the medical image data set based on the first        items of imaging data,    -   generation of the ultrasound data set based on the second items        of imaging data,    -   determination of the transformation for image registration of        the ultrasound data set and the medical image data set relative        to one another based on the first piece of positional        information.

According to one embodiment of the invention, the following steps areprovided:

-   -   generation of a fusion image based on the ultrasound data set,        the medical image data set and the transformation for image        registration of the ultrasound data set and the medical image        data set relative to one another,    -   outputting the fusion image.

The ultrasound data set and the medical image data set can be registeredrelative to one another based on the transformation for imageregistration. According to one embodiment of the invention, during thegeneration of the fusion image, the ultrasound data set and the medicalimage data set are registered relative to one another based on thetransformation for image registration. This in particular enables theimplementation of US-CT hybrid imaging.

According to one embodiment of the invention, the following steps areprovided:

-   -   acquisition of second items of locating data relating to a        patient via the locating system,    -   determination of second positional information relating to a        position of the patient relative to the reference system of the        medical imaging apparatus based on the second items of locating        data,    -   generation of augmented-reality information based on the fusion        image and based on the second positional information, wherein        augmented-reality information can be used to display the fusion        image superimposed on the patient,    -   outputting the augmented-reality information.

According to one embodiment of the invention, it is provided that themedical imaging apparatus comprises a control apparatus embodied tocontrol the medical imaging apparatus and to control the ultrasoundprobe, wherein the control apparatus comprises an interface, whereincontrol commands are output to the ultrasound probe via the interfaceand/or wherein the second items of imaging data are received from theultrasound probe via the interface.

The synchronization facility for setting an operating state of a medicalimaging apparatus in dependence on a temporal course of a movement of ananatomical structure and/or in dependence on a spatial distribution ofan ultrasound contrast medium in the anatomical structure comprises thefollowing components:

-   -   an ultrasound data set provisioning module embodied for the        provision of an ultrasound data set relating to a temporal        course of a movement of the anatomical structure and/or a        spatial distribution of an ultrasound contrast medium in the        anatomical structure,    -   a trigger time determining module embodied to determine a        trigger time based on the ultrasound data set,    -   a trigger command output module embodied to output a trigger        command on the onset of the trigger time, wherein the trigger        command effects the setting of the operating state of the        medical imaging apparatus.

According to one embodiment of the invention, it is provided that thesystem and/or the control apparatus comprises the synchronizationfacility.

Another embodiment of the present application is directed to a methodfor the determination of a flow parameter relating to a fluid flowand/or directed to a flow parameter determining facility. This isdiscussed in more detail in German application number DE 102016203809.5filed Mar. 9, 2016, the entire contents of which are hereby incorporatedherein by reference.

In at least one embodiment, the method for the determination of a flowparameter relating to a fluid flow in a segment of a vessel comprisesthe following steps:

-   -   provision of an ultrasound data set relating to a region to be        depicted in which the vessel is located,    -   provision of a medical image data set recorded on the basis of        electromagnetic radiation and relating to the region to be        depicted,    -   determination of positional information with which the segment        of the vessel can be localized in the ultrasound data set based        on the medical image data set,    -   determination of the flow parameter relating to the fluid flow        in the segment of the vessel relates to based on the ultrasound        data set and based on the positional information.

The medical image data set can, for example, relate to an, in particularcoronary, angiography and/or be temporally correlated with theheartbeat. The vessel can in particular be a coronary vessel. During thedetermination of the positional information, it is in particularpossible for the segment of the vessel to be identified based on themedical image data set and/or selected for a determination of the flowparameter. The determination of the flow parameter can, for example,take place within the context of a fractional flow reserve (FFR)examination. The vessel can, in particular, be a coronary vessel.

The positional information can in particular be coordinates of datapoints, for example image points, in the ultrasound data set and/or inthe medical image data set which are assigned to the segment of thevessel. The positional information can, for example, be used as a basisfor marking a position of the segment of the vessel in an ultrasoundimage of the ultrasound data set. This enables a non-invasive FFRexamination to be performed in particular without using electromagneticradiation and a contrast medium for the electromagnetic radiation beyondthe recording of the medical image data set. Hence, the inventionenables a non-invasive in-vivo fractional flow reserve examination withminimal use of X-rays and contrast medium. This also enables thesedation of the patient to be dispensed with in a catheter laboratorythus enabling the FFR examination to be performed inexpensively and withimproved patient comfort.

According to one embodiment of the invention, it is provided that theultrasound data set comprises Doppler sonography scan data. In thecontext of this application, the term color Doppler should be understoodto mean color-coded Doppler-sonography (CCDS). Color Doppler ultrasoundprobes are able to measure blood flow even in relatively small vessels.However, due to the high dynamics of the heart muscle, in many cases,this is not possible or only conditionally possible with the relativelysmall coronary vessels. The positional information, for example, enablesthe position of the coronary vessels to be superimposed within thesonography image during an examination of the heart via Dopplersonography.

According to one embodiment of the invention, it is provided that asub-region of the vessel is automatically identified based on themedical image data set and/or that the positional information isdetermined based on the automatically identified sub-region of thevessel.

The sub-region can, for example, be an anomaly, in particular a narrowpoint (stenosis), of the vessel. The segment of the vessel can inparticular be a segment of the vessel located behind and/or before thenarrow point of the vessel with respect to a direction of the fluidflow. It is in particular possible for a volume within which the flowparameter is determined to be automatically restricted to theautomatically identified sub-region.

Skilled image registration of the medical image data set and theultrasound data set relative to one another in connection with automaticidentification (tracking) of the stenosis over the cardiac cycle enablesthis FFR examination to be performed almost completely automatically.When a computed tomography device is used as the medical imagingapparatus, the narrow points can, for example, examined withquantum-counting detectors and/or a material dissection for the contentof certain materials, for example the calcium content.

According to one embodiment of the invention, it is provided that themedical image data set comprises a plurality of temporally successiveimages each relating to the region to be depicted and/or that thepositional information relates to a plurality of temporally successivepositions of the segment of the vessel in the ultrasound data set.

According to one embodiment of the invention, it is provided that,during the determination of the positional information, an interpolatedposition of the segment of the vessel in the ultrasound data set isdetermined and/or that the interpolated position is assigned to a timeoccurring between the times of two immediately temporally successiveimages in the plurality of temporally successive images. In particular,the movement of the coronary vessels can be interpolated between thetimes of the images, in particular the recordings. Hence, the positionof the segment of the vessel, in particular the coronary vessel, can belocalized both in the three-dimensional space and temporally over theheartbeat phases. The can in particular take placed based on the firstitems of locating data and/or the second items of locating data.Compute-intensive steps of the interpolation can, for example, beoutsourced to a cloud.

According to one embodiment of the invention, it is provided that theplurality of temporally successive images for each heartbeat phase in aplurality of heartbeat phases comprises at least one image assigned tothe respective heartbeat phase and/or that the plurality of temporallysuccessive positions of the segment for each heartbeat phase in theplurality of heartbeat phases comprises at least one position assignedto the respective heartbeat phase. The heartbeat phases can inparticular be understood to mean different heartbeat phases of a cardiaccycle. It, for example, possible for a plurality of angiograms to beperformed in different heartbeat phases and for the movement of coronaryvessels to be interpolated between the times of the images, inparticular the recordings.

According to one embodiment of the invention, it is provided that thevessel is a blood vessel is and/or wherein the fluid flow is a bloodflow. The fluid can in particular be blood and/or ablood/contrast-medium mixture.

According to one embodiment of the invention, it is provided that theflow parameter is selected from the parameter group consisting of aspeed, a direction, a density, a pressure and an energy of the fluidflow. The density can in particular be a particle density and/or a massdensity.

According to one embodiment of the invention, the following steps areprovided:

-   -   acquisition of first items of imaging data of the region to be        depicted via a medical imaging apparatus based on        electromagnetic radiation,    -   reconstruction of the medical image data set based on the first        items of imaging data.

The provision of the medical image data set can, for example, includethe reconstruction of the medical image data set based on the firstitems of imaging data and/or the acquisition of the first items ofimaging data via the medical imaging apparatus. Alternatively oradditionally thereto, the provision of the medical image data set caninclude loading the medical image data set from an image database.According to one embodiment of the invention, the following steps areprovided:

-   -   acquisition of second items of imaging data via an ultrasound        probe,    -   generation of the ultrasound data set based on the second items        of imaging data.

The provision of the ultrasound data set can, for example, include thegeneration of the ultrasound data set based on the second items ofimaging data and/or the acquisition of the second items of imaging datavia the ultrasound probe. Alternatively or additionally thereto, theprovision of the ultrasound data set can include loading the ultrasounddata set from an image database.

According to one embodiment of the invention, the following steps areprovided:

-   -   determination of a transformation for image registration of the        ultrasound data set and the medical image data set,    -   registration of the ultrasound data set and the medical image        data set relative to one another based on the transformation for        image registration.

The transformation for image registration can in particular bedetermined by way of a method described in this application for thedetermination of a transformation of an ultrasound data set and amedical image data set recorded with electromagnetic radiation relativeto one another.

According to one embodiment of the invention one or more of followingcomponents is/are provided:

-   -   an ultrasound data set provisioning module embodied for the        provision of an ultrasound data set relating to a region to be        depicted in which the vessel is located,    -   an image data set provisioning module embodied for the provision        of a medical image data set recorded on the basis of        electromagnetic radiation and relating to the region to be        depicted,    -   a positional information determining module embodied to        determine positional information with which the segment of the        vessel in the ultrasound data set can be localized and/or        relating to a position of the segment of the vessel based on the        medical image data set,    -   a flow parameter determining module embodied for the        determination of the flow parameter relating to the fluid flow        through the segment of the vessel based on the ultrasound data        set and based on the positional information.

The flow parameter determining facility for the determination of a flowparameter relating to a fluid flow through a segment of a vesselcomprises the following components:

-   -   an ultrasound data set provisioning module,    -   an image data set provisioning module,    -   a positional information determining module,    -   a flow parameter determining module.

In particular, the positional information determining module can beembodied to select a sub-region of the vessel based on the medical imagedata set and/or to determine the positional information based on theselected sub-region of the vessel.

According to one embodiment of the invention, it is provided that theflow parameter determining facility is embodied to carry out a methodfor the determination of a flow parameter according to one or more ofthe embodiments described in this application.

According to one embodiment of the invention, it is provided that thesystem comprises the following components:

-   -   a medical imaging apparatus embodied for the acquisition of        first items of imaging data based on electromagnetic radiation,    -   the flow parameter determining facility.

According to one embodiment of the invention, it is provided that thesystem is embodied to carry out a method according to one or more of theembodiments described in this application. The system is in particularembodied to carry out a given step when the system comprises a componentembodied to carry out the given step.

One embodiment of the invention provides that the control apparatus isformed by a computer and/or that one or more components of the controlapparatus are formed at least partially by a computer. The computer can,for example, comprise a memory facility and/or a processor system. Theprocessor system can, for example, comprise a microprocessor and/or aplurality of interacting microprocessors. One embodiment of theinvention provides that the control apparatus and/or one or morecomponents of the control apparatus is or are implemented at leastpartially in the form of software on a processor system.

One embodiment of the invention provides that the control apparatusand/or one or more components of the control apparatus is or areimplemented at least partially in the form of hardware. The hardwarecan, for example, be an FPGA system (Field-programmable gate array), anASIC system (application-specific integrated circuit), a microcontrollersystem, a processor system and combinations thereof. The hardware can,for example, interact with software and/or be configured by way ofsoftware. One embodiment of the invention provides that the controlapparatus and/or one or more components of the control apparatus is orare at least partially formed by a cloud via cloud computing. The cloudcan in particular comprise a network of memory regions that arespatially separated from one another and processor systems that arespatially separated from one another. The control apparatus can comprisea first cloud interface for the data transfer from the cloud and/or tothe cloud.

Data transfer between components of the control apparatus can, forexample, in each case take place via a suitable data transfer interface.One embodiment of the invention provides that data transfer interfacesfor transferring data to and/or from components of the control apparatusare implemented at least partially in the form of software and/or atleast partially in the form of hardware. In particular, the interfacescan comprises means for accessing suitable memory regions in which datacan be suitably buffered, retrieved and updated.

In particular with an extensively software-based implementation of thecontrol apparatus, a computer can be embodied by way of software suchthat the computer can carry out the steps of a method according to atleast one embodiment of the invention. Hence, the object is in each caseachieved by the computer program according to at least one embodiment ofthe invention, the computer-readable medium according to at least oneembodiment of the invention and the computer program product accordingto at least one embodiment of the invention.

The computer program according to at least one embodiment of theinvention can be loaded into a memory facility of a computer. Thecomputer program carries out the steps of a method according to at leastone embodiment of the invention when the computer program is executed onthe computer. A computer program according to at least one embodiment ofthe invention is stored on the computer-readable medium according to atleast one embodiment of the invention. In particular, thecomputer-readable medium can be embodied to transport the computerprogram and/or to store the computer program.

According to one embodiment of the invention, the computer-readablemedium is a memory stick, a hard disk or some other kind of a datamedium that can, for example, be transportable or permanently installed.The computer program according to at least one embodiment of theinvention product comprises a computer program according to theinvention and/or a computer-readable medium according to at least oneembodiment of the invention. In addition to the computer program and/orthe computer-readable medium, the computer program product can includeadditional software components, for example documentation, and/oradditional hardware components, for example a hardware key (dongle etc.)for using the software.

One embodiment of the invention provides that the described methodand/or one or more steps of the described method is or are in each casecarried out automatically and/or fully automatically. In particular, asub-region of the vessel can be identified automatically and/or fullyautomatically based on the medical image data set.

In the context of the present application, “automatically” means thatthe respective step is carried out independently by way of softwareand/or by way of hardware and/or that the respective step substantiallydoes not require any interaction with a user. In particular,substantially no interaction is required if the user only accepts orrejects one or more automatically generated suggestions. In the contextof the present application, “fully automatically” means that nointeraction at all with a user is needed to carry out the respectivestep. Regardless of whether one or more steps are carried out“automatically” or “fully automatically”, the method according to atleast one embodiment of the invention can be a component of an operatingsequence that additionally requires interaction with a user. Theinteraction of the user can, for example, reside in the fact that theuser compiles or selects an examination protocol and/or an examinationplan and/or a clinical issue manually, for example from a menu presentedvia a screen.

In the context of at least one embodiment of the invention, featuresdescribed with regard to different embodiments of the invention and/ordifferent claim categories (apparatus, method etc.) can be combined toform further embodiments of the invention. In other words, thesubstantive claims can also be developed with the features described orclaimed in connection with a method. Functional features of a methodaccording to at least one embodiment of the invention can also becarried out by correspondingly embodied substantive components. Inaddition to the embodiments of the invention expressly described in thisapplication, multiple further embodiments of the invention areconceivable which the person skilled in the art will be able to arriveat without leaving the scope of the invention as described in theclaims.

The use of indefinite article “a” or “an” does not preclude thepossibility of the features in question also being present on a multiplebasis. The use of the term “comprise” does not preclude the possibilityof the terms being linked by the term “comprise” being identical. Forexample the medical imaging apparatus comprises the medical imagingapparatus. The use of the term “unit” does not preclude the possibilityof the subject matter to which the term “unit” relates comprising aplurality of components that are spatially separated from one another.In the context of the present application, the use of ordinal numbers(first, second, third etc.) in the description of features is primarilyfor better distinction of features described using ordinal numbers. Theabsence of a feature described by a combination of a given ordinalnumber and of a term does not preclude the possibility of a featurebeing present that is also described by a combination of an ordinalnumber following the given ordinal number and the term.

In the context of the present application, the expression “based on” canin particular be understand as meaning “using”. In particular, wordingaccording to which a first feature is created (alternatively:determined, identified etc.) based on a second feature does not precludethe possibility of the first feature being created (alternatively:determined, identified etc.) based on a third feature.

FIG. 1 shows a schematic representation of the system 1 according to afirst embodiment of the invention. The system 1 comprises the medicalimaging apparatus 2, the control apparatus 30, the ultrasound probe TP,the injection apparatus IU, the location system LS and theaugmented-reality apparatus AD.

Without restricting the general concept of the invention, a computedtomography device is shown by way of example for the medical imagingapparatus 2. The medical imaging apparatus 2 comprises the gantry 20,the tunnel-shaped opening 9, the patient support apparatus 10 and thecontrol apparatus 30. The gantry 20 comprises the stationary carryingframe 21 and the rotor 24. The rotor 24 is arranged rotatably on thestationary carrying frame 21 about an axis of rotation relative to thestationary carrying frame 21 by way of a rotary bearing apparatus. Thepatient 13 can be introduced into the tunnel-shaped opening 9. Theacquisition region 4 is located in the tunnel-shaped opening 9. In theacquisition region 4, a region to be depicted of the patient 13 can bepositioned such that the radiation 27 can travel from the radiationsource 26 to the region to be depicted and, following interaction withthe region to be depicted, travel to the radiation detector 28. Thepatient support apparatus 10 comprises the supporting table 11 and thetransfer plate 12 for supporting the patient 13. The transfer plate 12is arranged movably on the supporting table 11 relative to thesupporting table 11 such that the transfer plate 12 can be introducedinto the acquisition region 4 in a longitudinal direction of thetransfer plate 12.

The medical imaging apparatus 2 is embodied for the acquisition A1 offirst items of imaging data based on electromagnetic radiation 27. Themedical imaging apparatus 2 comprises an imaging data acquisition unit.The imaging data acquisition unit is a projection data acquisition unitwith the radiation source 26, for example an X-ray source, and thedetector 28, for example an X-ray detector, in particular anenergy-resolving X-ray detector. The radiation source 26 is arranged onthe rotor 24 and embodied for the emission of radiation 27, for exampleX-rays, with radiation quanta 27. The detector 28 is arranged on therotor 24 and embodied to detect the radiation quanta 27. The radiationquanta 27 can travel from the radiation source 26 to the region to bedepicted of the patient 13 and, following interaction with the region tobe depicted, arrive at the detector 28. In this way, the imaging dataacquisition unit is able to acquire first items of imaging data of theregion to be depicted in the form of projection data.

The control apparatus 30 is embodied to receive the first items ofimaging data acquired from the imaging data acquisition unit. Thecontrol apparatus 30 is embodied to control the medical imagingapparatus 2. The control apparatus 30 comprises the image reconstructionfacility 34. The image reconstruction facility 34 can reconstruct amedical image data set based on the first items of imaging data. Thecontrol apparatus 30 is further embodied to control the ultrasound probeTP. The control apparatus 30 comprises the interface CI which isembodied to output control commands to control the ultrasound probe TPto the ultrasound probe TP. The ultrasound probe TP can be connected tothe control apparatus 30 via the interface OI.

The control apparatus 30 comprises the synchronization facility 35 andthe flow parameter determining facility 36. The control apparatus 30comprises a computer 30 and a tablet computer TC. The computer 30comprises a memory facility 31 and a processor system. A computerprogram, which is stored on the computer-readable medium 32, can beloaded into the memory facility 31 of the computer 30. The computer 30is embodied to execute the computer program. The medical imagingapparatus 2 comprises an input apparatus 38 and an output apparatus 39each of which are connected to the control apparatus 30. The inputapparatus 38 is embodied to input control information, for example imagereconstruction parameters and/or examination parameters. The outputapparatus 39 is in particular embodied to output control information,images and/or sounds.

The augmented-reality apparatus AD is connected to the control apparatus30 and is embodied both to input control information and to displayaugmented-reality information, the fusion image, the medical image dataset, the ultrasound data set and/or further information. Theaugmented-reality apparatus AD can be used to display theaugmented-reality information in a field of view of the user U1. Thelocation system LS comprises the camera system KS and the optical sensorsystem OS.

FIG. 2 shows a schematic representation of the control apparatus 30. Thecontrol apparatus 30 comprises the ultrasound data set generation moduleGU-M, the first positional information determining module L1-M, thetransformation determining module DT-M, the fusion image generatingmodule GF-M, the fusion image output module OF-M, the second positionalinformation determining module L2-M, the augmented-reality informationgenerating module GA-M and the augmented-reality information outputmodule GA-M. The control apparatus 30 is connected to theaugmented-reality apparatus AD and the location system LS. Theultrasound probe TP is connected to the control apparatus 30 via theinterface OI. The ultrasound probe TP comprises a data transmissionmodule TPC embodied to receive the control commands from the interfaceOI and to output the second items of imaging data to the interface OI.The data transmission module TPC comprises a data transmission connectorembodied for direct data transmission of the control commands from theinterface OI and/or for direct data transmission of the second items ofimaging data to the interface OI.

FIG. 3 shows a schematic representation of the synchronization facility35 according to a second embodiment of the invention. Thesynchronization facility 35 comprises the ultrasound data setprovisioning module PU-M, the trigger time determining module DG-M andthe trigger command output module OG-M.

FIG. 4 shows a schematic representation of the flow parameterdetermining facility 36. The flow parameter determining facility 36comprises the ultrasound data set provisioning module PU-M, the imagedata set provisioning module PI-M, the positional informationdetermining module DP-M and the flow parameter determining module DW-M.

FIG. 5 shows a flow diagram of a method for the determination of atransformation for image registration of an ultrasound data set and amedical image data set recorded with electromagnetic radiation 27relative to one another according to a third embodiment of theinvention. The method shown in FIG. 5 comprises the following steps:

-   -   acquisition A1 of first items of imaging data via a medical        imaging apparatus 2 based on electromagnetic radiation 27,    -   acquisition A2 of second items of imaging data via an ultrasound        probe TP,    -   acquisition S1 of first items of locating data relating to the        ultrasound probe TP via a locating system LS selected from the        location system group including of a camera system KS, an        optical sensor system OS, a light reflection system, a radio        direction-finding system and combinations thereof,    -   determination L1 of a first piece of positional information        relating to a position of the ultrasound probe TP relative to a        reference system of the medical imaging apparatus 2, based on        the first items of locating data,    -   reconstruction RI of the medical image data set based on the        first items of imaging data,    -   generation GU of the ultrasound data set based on the second        items of imaging data, and    -   determination DT of the transformation for image registration.

The method shown in FIG. 5 further comprises the following steps:

-   -   generation GF of a fusion image based on the ultrasound data        set, the medical image data set and the transformation for image        registration of the ultrasound data set and the medical image        data set relative to one another,    -   outputting OF the fusion image,    -   acquisition S2 of second items of locating data relating to a        patient 13, via the locating system LS,    -   determination L2 of second positional information relating to a        position of the patient 13 relative to the reference system of        the medical imaging apparatus 2 based on the second items of        locating data,    -   generation GA of augmented-reality information based on the        fusion image and based on the second positional information,        wherein augmented-reality information can be used to display the        fusion image superimposed on the patient 13,    -   outputting OA the augmented-reality information.

FIG. 6 shows a flow diagram of a method for setting an operating stateof the medical imaging apparatus 2 according to a fourth embodiment ofthe invention. The method shown in FIG. 6 comprises the following steps:

-   -   acquisition A2 of second items of imaging data of a region to be        depicted in which the anatomical structure is located via an        ultrasound probe TP,    -   generation GU of the ultrasound data set based on the second        items of imaging data,    -   provision PU of an ultrasound data set relating to a temporal        course of a movement of the anatomical structure and/or a        spatial distribution of an ultrasound contrast medium in the        anatomical structure,    -   determination DG of a trigger time based on the ultrasound data        set,    -   outputting OG a trigger command on the onset of the trigger        time, wherein the trigger command effects the setting of the        operating state of the medical imaging apparatus 2.    -   acquisition A1 of the first items of imaging data via the        medical imaging apparatus 2 based on the electromagnetic        radiation 27.

FIG. 7 shows a flow diagram of a method for the determination of a flowparameter relating to a fluid flow in a segment VS1, VS2 of a vessel V.The method shown in FIG. 7 comprises the following steps:

-   -   provision PU of an ultrasound data set relating to a region to        be depicted in which the vessel V is located,    -   provision PI of a medical image data set recorded based on        electromagnetic radiation 27 and relating to the region to be        depicted,    -   determination DT of a transformation for image registration of        the ultrasound data set and the medical image data set,    -   registration RT of the ultrasound data set and the medical image        data set relative to one another based on the transformation for        image registration,    -   determination DP of positional information with which the        segment VS1, VS2 of the vessel V can be localized in the        ultrasound data set based on the medical image data set,    -   determination DW of the flow parameter relating to the fluid        flow in the segment VS1, VS2 of the vessel V based on the        ultrasound data set and based on the positional information.

The flow parameter determining facility 36 is embodied to carry out amethod for the determination of a flow parameter, relating to a fluidflow in a segment VS1, VS2 of a vessel V according to one of theembodiments described in this application. In particular, the methodshown in FIG. 7 can be used for the determination of a flow parametervia the flow parameter determining facility 36.

FIG. 8 shows a schematic representation of the vessel V. The sub-regionVP of the vessel V is a narrow point (stenosis). The direction of thefluid flow is indicated by arrows. The segment VS1 of the vessel V islocated with regard to the direction of the fluid flow before the narrowpoint VP. The segment VS2 of the vessel V is located with regard to thedirection of the fluid flow after the narrow point VP.

The patent claims of the application are formulation proposals withoutprejudice for obtaining more extensive patent protection. The applicantreserves the right to claim even further combinations of featurespreviously disclosed only in the description and/or drawings.

References back that are used in dependent claims indicate the furtherembodiment of the subject matter of the main claim by way of thefeatures of the respective dependent claim; they should not beunderstood as dispensing with obtaining independent protection of thesubject matter for the combinations of features in the referred-backdependent claims. Furthermore, with regard to interpreting the claims,where a feature is concretized in more specific detail in a subordinateclaim, it should be assumed that such a restriction is not present inthe respective preceding claims.

Since the subject matter of the dependent claims in relation to theprior art on the priority date may form separate and independentinventions, the applicant reserves the right to make them the subjectmatter of independent claims or divisional declarations. They mayfurthermore also contain independent inventions which have aconfiguration that is independent of the subject matters of thepreceding dependent claims.

None of the elements recited in the claims are intended to be ameans-plus-function element within the meaning of 35 U.S.C. §112(f)unless an element is expressly recited using the phrase “means for” or,in the case of a method claim, using the phrases “operation for” or“step for.”

Example embodiments being thus described, it will be obvious that thesame may be varied in many ways. Such variations are not to be regardedas a departure from the spirit and scope of the present invention, andall such modifications as would be obvious to one skilled in the art areintended to be included within the scope of the following claims.

What is claimed is:
 1. A system, comprising: a medical imaging apparatusembodied to acquire first items of imaging data based on electromagneticradiation; and a control apparatus embodied to control the medicalimaging apparatus and to control an ultrasound probe, the controlapparatus including an interface embodied to output control commands tothe ultrasound probe, wherein the ultrasound probe is connectable to thecontrol apparatus via the interface.
 2. The system of claim 1, furthercomprising the ultrasound probe.
 3. The system of claim 1, wherein theultrasound probe is embodied to acquire second items of imaging data. 4.The system of claim 1, wherein the interface is embodied to receive thesecond items of imaging data from the ultrasound probe.
 5. The system ofclaim 1, wherein the control apparatus further includes an ultrasounddata set generation module embodied to generate an ultrasound data setbased on the second items of imaging data.
 6. The system of claim 1,wherein the ultrasound probe is connected to the control apparatus viathe interface.
 7. The system of claim 1, wherein the interface is atleast one of an open and universal interface.
 8. The system of claim 1,wherein the interface is selected from the interface group consisting ofa USB interface, a FireWire interface, a Bluetooth interface andcombinations thereof.
 9. The system of claim 1, wherein the controlapparatus further includes a mobile control unit, and wherein the mobilecontrol unit comprises the interface.
 10. The system of claim 1, whereinthe mobile control unit is a tablet computer.
 11. The system of claim 1,wherein the medical imaging apparatus comprises at least one of a gantryand a patient support apparatus, and wherein the mobile control unit isat least one of arranged and arrangeable on the at least one of thegantry and the patient support apparatus.
 12. The system of claim 1,further comprising: an injection apparatus, embodied to apply a contrastmedium for the acquisition of the first items of imaging data based onat least one of the electromagnetic radiation and an ultrasound contrastmedium.
 13. The system of claim 1, further comprising: a location systemselected from a location system group including a camera system, anoptical sensor system, a light reflection system, a radiodirection-finding system and combinations thereof, wherein the locationsystem is embodied to acquire at least one of first items of locatingdata relating to the ultrasound probe and second items of locating datarelating to a patient.
 14. The system of claim 13, wherein the controlapparatus further comprises: a first positional information determiningmodule embodied to determine a first piece of positional informationrelating to a position of the ultrasound probe relative to a referencesystem of the medical imaging apparatus based on the first items oflocating data, and a transformation determining module embodied todetermine a transformation for image registration of an ultrasound dataset and a medical image data set based on the first piece of positionalinformation.
 15. The system of claim 14, wherein the control apparatusfurther comprises: a fusion image generating module embodied to generatea fusion image based on the ultrasound data set, the medical image andthe transformation for image registration of the ultrasound data set andthe medical image data set, and a fusion image output module embodied tooutput the fusion image.
 16. The system of claim 15, wherein the controlapparatus further comprises: a second positional information determiningmodule embodied to determine second positional information relating to aposition of the patient relative to the reference system of the medicalimaging apparatus based on the second items of locating data, anaugmented-reality information generating module embodied to generateaugmented-reality information based on the fusion image and based on thesecond positional information, wherein augmented-reality information isuseable to display the fusion image superimposed on the patient, and anaugmented-reality information output module embodied to output theaugmented-reality information.
 17. A method for setting an operatingstate of a medical imaging apparatus embodied to acquire first items ofimaging data based on electromagnetic radiation in dependence on atleast one of a temporal course of a movement of an anatomical structureand a spatial distribution of an ultrasound contrast medium in theanatomical structure, the method comprising: provisioning an ultrasounddata set relating to a temporal course of a movement of at least one ofthe anatomical structure and a spatial distribution of an ultrasoundcontrast medium in the anatomical structure; determining a trigger timebased on the ultrasound data set; and outputting a trigger command onthe onset of the trigger time, wherein the trigger command affects thesetting of the operating state of the medical imaging apparatus.
 18. Themethod of claim 17, further comprising: acquiring second items ofimaging data of a region to be depicted in which the anatomicalstructure is located via an ultrasound probe; and generating theultrasound data set based on the second items of imaging data.
 19. Themethod of claim 17, further comprising: acquiring the first items ofimaging data via the medical imaging apparatus based on theelectromagnetic radiation.
 20. A method for determining of atransformation for image registration of an ultrasound data set and amedical image data set recorded with electromagnetic radiation, themethod comprising: acquiring first items of imaging data via a medicalimaging apparatus based on electromagnetic radiation; acquiring seconditems of imaging data via an ultrasound probe; acquiring first items oflocating data relating to the ultrasound probe via a locating systemselected from the location system group consisting of a camera system,an optical sensor system, a light reflection system, a radiodirection-finding system and combinations thereof; determining a firstpiece of positional information relating to a position of the ultrasoundprobe relative to a reference system of the medical imaging apparatusbased on the first items of locating data; reconstructing the medicalimage data set based on the first items of imaging data; generating theultrasound data set based on the second items of imaging data; anddetermining the transformation for image registration of the ultrasounddata set and the medical image data set based on the first piece ofpositional information.
 21. The method of claim 20, further comprising:generating a fusion image based on the ultrasound data set, the medicalimage data set and the transformation for image registration of theultrasound data set and the medical image data set; and outputting thefusion image.
 22. The method of claim 20, further comprising: acquiringsecond items of locating data relating to a patient via the locatingsystem; determining second positional information relating to a positionof the patient relative to the reference system of the medical imagingapparatus based on the second items of locating data; generatingaugmented-reality information based on the fusion image and based on thesecond positional information, wherein augmented-reality information isuseable to display the fusion image superimposed on the patient; andoutputting the augmented-reality information.
 23. The method of claim17, wherein the medical imaging apparatus comprises a control apparatusembodied to control the medical imaging apparatus and to control theultrasound probe, wherein the control apparatus comprises an interface,and wherein at least one of control commands are output to theultrasound probe via the interface, and the second items of imaging dataare received from the ultrasound probe via the interface.
 24. Asynchronization facility for setting an operating state of a medicalimaging apparatus in dependence on at least one of a temporal course ofa movement of an anatomical structure and a spatial distribution of anultrasound contrast medium in the anatomical structure, thesynchronization facility comprising: an ultrasound data set provisioningmodule embodied to provision an ultrasound data set relating to at leastone of the temporal course of a movement of the anatomical structure andthe spatial distribution of an ultrasound contrast medium in theanatomical structure; a trigger time determining module embodied todetermine a trigger time based on the ultrasound data set; and a triggercommand output module embodied to output a trigger command on the onsetof the trigger time, wherein the trigger command is configured to affectthe setting of the operating state of the medical imaging apparatus. 25.The system of claim 1, wherein at least one of the system and thecontrol apparatus includes a synchronization facility comprising: anultrasound data set provisioning module embodied to provision anultrasound data set relating to at least one of a temporal course of amovement of the anatomical structure and a spatial distribution of anultrasound contrast medium in the anatomical structure; a trigger timedetermining module embodied to determine a trigger time based on theultrasound data set; and a trigger command output module embodied tooutput a trigger command on the onset of the trigger time, wherein thetrigger command is configured to affect the setting of the operatingstate of the medical imaging apparatus.
 26. The system of claim 16embodied to carry out a method comprising: provisioning an ultrasounddata set relating to a temporal course of a movement of at least one ofthe anatomical structure and a spatial distribution of an ultrasoundcontrast medium in the anatomical structure; determining a trigger timebased on the ultrasound data set; and outputting a trigger command onthe onset of the trigger time, wherein the trigger command affects thesetting of the operating state of the medical imaging apparatus.
 27. Thesystem of claim 2, wherein the ultrasound probe is embodied to acquiresecond items of imaging data.
 28. The system of claim 2, wherein theinterface is embodied to receive the second items of imaging data fromthe ultrasound probe.
 29. The system of claim 2, wherein the controlapparatus further includes an ultrasound data set generation moduleembodied to generate an ultrasound data set based on the second items ofimaging data.
 30. The system of claim 2, wherein the control apparatusfurther comprises a mobile control unit, and wherein the mobile controlunit comprises the interface.
 31. The system of claim 2, wherein themedical imaging apparatus comprises at least one of a gantry and apatient support apparatus, and wherein the mobile control unit is atleast one of arranged and arrangeable on the at least one of the gantryand the patient support apparatus.
 32. The system of claim 2, furthercomprising: an injection apparatus, embodied to apply a contrast mediumfor the acquisition of the first items of imaging data based on at leastone of the electromagnetic radiation and an ultrasound contrast medium.33. The system of claim 2, further comprising: a location systemselected from a location system group including a camera system, anoptical sensor system, a light reflection system, a radiodirection-finding system and combinations thereof, wherein the locationsystem is embodied to acquire at least one of first items of locatingdata relating to the ultrasound probe and second items of locating datarelating to a patient.
 34. The system of claim 33, wherein the controlapparatus further comprises: a first positional information determiningmodule embodied to determine a first piece of positional informationrelating to a position of the ultrasound probe relative to a referencesystem of the medical imaging apparatus based on the first items oflocating data, and a transformation determining module embodied todetermine a transformation for image registration of an ultrasound dataset and a medical image data set based on the first piece of positionalinformation.
 35. The system of claim 34, wherein the control apparatusfurther comprises: a fusion image generating module embodied to generatea fusion image based on the ultrasound data set, the medical image andthe transformation for image registration of the ultrasound data set andthe medical image data set, and a fusion image output module embodied tooutput the fusion image.
 36. The system of claim 35, wherein the controlapparatus further comprises: a second positional information determiningmodule embodied to determine second positional information relating to aposition of the patient relative to the reference system of the medicalimaging apparatus based on the second items of locating data, anaugmented-reality information generating module embodied to generateaugmented-reality information based on the fusion image and based on thesecond positional information, wherein augmented-reality information isuseable to display the fusion image superimposed on the patient, and anaugmented-reality information output module embodied to output theaugmented-reality information.
 37. The method of claim 18, furthercomprising: acquiring the first items of imaging data via the medicalimaging apparatus based on the electromagnetic radiation.
 38. The methodof claim 21, further comprising: acquiring second items of locating datarelating to a patient via the locating system; determining secondpositional information relating to a position of the patient relative tothe reference system of the medical imaging apparatus based on thesecond items of locating data; generating augmented-reality informationbased on the fusion image and based on the second positionalinformation, wherein augmented-reality information is useable to displaythe fusion image superimposed on the patient; and outputting theaugmented-reality information.
 39. A non-transitory computer readablemedium including program code for carrying out the method of claim 17when the program code is run in a computer.
 40. A non-transitorycomputer readable medium including program code for carrying out themethod of claim 20 when the program code is run in a computer.